Placental tissue histopathological changes related with intrauterine fetal death today compared with these changes before 10 years

Ciljevi istraživanja: Usporediti pojavnost mrtvorođenosti u KBC Osijek u kalendarski najbližem trogodišnjem razdoblju (2014. - 2016.) te razdoblju prije 10 godina (2004. - 2006.) prema spolu, masi i duljini ploda, gestacijskoj i majčinoj dobi. Nadalje, usporediti patološko-anatomske promjene plodova i patohistološke promjene posteljica kod mrtvorođenosti u ispitivanim razdobljima, te utvrditi odnos tih posteljičnih promjena prema životnoj dobi majke i gestacijskoj dobi. Nacrt studije: Presječna studija. Ispitanici, materijali i metode: U istraživanje je uključeno 63 mrtvorođenčeta, 35 iz razdoblja prije 10 godina i 28 iz najbližeg razdoblja današnjici, te ukupno 63 pripadajuće posteljice. Podatci o patološko-anatomskim promjenama mrtvorođenčeta i patohistološkim promjenama posteljice mrtvorođenčeta dobiveni su iz arhivske medicinske dokumentacije. Podatci o trajanju gestacije i majčinoj dobi u vrijeme porođaja dobiveni su iz prateće dokumentacije. Rezultati: Značajno više torzija pupkovine zabilježeno je u razdoblju od 2004. do 2006. godine, njih 11 (31 %) (Fisherov egzaktni test, P = 0,03), a također su dijagnosticirane kod mlađih majki, medijana dobi 24 godine (interkvartilnog raspona od 22 do 29 godina) (Mann-Whitney U test, P = 0,003). Korioamnionitis (Fisherov egzaktni test, P = 0,005) i upala pupkovine (Fisherov egzaktni test, P = 0,008) značajnije se pojavljuju od 22. do 27. tjedna gestacije. U raspodjeli ispitanika i tkiva posteljice, s obzirom na ostale proučavane varijable, između ispitivanih skupina nije utvrđena značajna razlika. Zaključak: U ispitivanim razdobljima s vremenskim odmakom od 10 godina nisu utvrđena odstupanja patoloških obilježja posteljica kod mrtvorođenih, osim u slučaju torzije pupkovine. Patološka obilježja posteljica i mrtvorođenosti treba nastaviti promatrati kroz dugo razdoblje.Aim of research: To compare the incidence of stillbirth in the Clinical Hospital Centre Osijek in the nearest triennial period (2014 – 2016) and the period of three years over 10 years ago (2004 – 2006) according to gender, mass and length of the fetuses, gestational age and maternal age. Furthermore, the aim is to compare pathoanatomical changes of fetuses and pathohistological changes of placentas in stillborns in the researched time periods and to determine the relation between those placental changes, the age of the mother, and the gestational age. Study design: Cross – sectional study. Study subject, materials and methods: The research included 63 stillborn babies and 63 related placentas, 35 from the period of over 10 years ago and 28 from the period closer to the present. Data about the pathoanatomical changes in stillborn babies and pathohistological changes in stillborns’ placentas were obtained from the archived medical documentation. Data about the duration of gestation and maternal age at the time of birth were obtained from the supporting documentation. Results: There is significantly more umbilical cord torsion recorded in the period between 2004 and 2006, 11 of them (31 %) (Fisher’s exact test, P = 0.03). They have also been diagnosed in significantly younger mothers with the median age of 24 years (interquartile range between 22 and 29 years old) (Mann-Whitney U test, P = 0.003). Chorioamnionitis (Fisher’s exact test, P = 0.005) and umbilical cord infection (Fisher’s exact test, P = 0.008) appear more significantly between the 22nd and 27th week of gestation. Based on other studied variables, no significant difference between the subject groups has been established in the distribution of study subjects and placental tissue. Conclusion: In the studied time periods with the 10-year time distance, no pathological features deviations have been affirmed in stillborn babies, except in the case of umbilical cord torsion. Pathological features of placentas and stillborn babies should continue being observed over a long time period